A controversial extended medical break taken by tennis world number one Victoria Azarenka after losing five match points in her match against Sloane Stephens has raised the issue of “choking” in sport again.

In what appeared to be a panic attack, Azarenka said that she “couldn’t breathe” and “couldn’t swing” during that period of the match. She took a ten minute break (apparently because she tweaked her back), returned, and won the match.

Azarenka is not the first to “choke” in this year’s Australian Open. As a proud Australian, it was heartbreaking to watch our very own Sam Stosur lose from what appeared an un-losable position. Afterwards, she admitted it was “probably a choke”.

Azarneka has been accused of gamesmanship over the move. And she’s not the first to take a well-timed break in tennis. If we look back to past tennis champions such as Boris Becker and John McEnroe, it was very common to see them take “toilet breaks” whenever they were on the back foot. Did they feel themselves succumbing to the pressure? Perhaps … but only they can answer that question. Ultimately, it provided time to regain that competitive edge.

Choking is very common across all sports. Type “sport’s greatest chokes” into Google and you will find plenty of examples of what people perceive to be “choking”. For golf lovers, one only need look back to last years’ British Open where Adam Scott squandered a four shot lead on the final four holes of the tournament (disappointing for Aussie fans, again).

So, after all of that, what is a choke?

Researchers have studied this phenomenon extensively over the past few decades. In an unpublished review of choking, Dr. Christopher Mesagno and Dr. Denise Hill defined choking as a “considerable decrease in performance when self-expected standards are normally achievable, which is the result of increased anxiety under pressure”.

Sometimes choking is confused with poor performance, when, in reality, it is more than that – it is making drastically uncharacteristic mistakes due to the pressure that the performer is experiencing.

A common problem with research on choking is that it is near impossible to create a situation that resembles the pressures that elite sports people, such as Azerenka and Stosur, experience when playing in a major event.

Instead, researchers attempt to manipulate “pressure” situations using creative methods, such as performing for money. Such situations raise anxiety levels and provide a good indication of what occurs to a performer when required to execute skills under pressure.

There are two theories that propose why choking occurs. Distraction theories suggest that the performer’s attention is diverted to task-irrelevant thoughts, such as worries about the situation and potential consequences. Alternatively, self-focus theories argue that pressure causes individuals to focus on the task execution, which can potentially disrupt the automatic movements that we come to expect from professional athletes.

Given that Azarenka admitted she was “really panicking”, it would appear that her attention was distracted by thoughts of worry.

Research by Professor Rich Masters has shown certain individuals are more prone to consciously monitor their movements based on individual personality differences and, furthermore, are more likely to perform worse in pressure situations. He devised a questionnaire that identifies such individuals. It would be interesting to ascertain how some of our professional athletes labelled as “chokers” would fare on this questionnaire.

In the meantime, the important question we should be asking is whether taking “extended breaks” when feeling the pressure, as Azarenka did, is in the spirit of the game. I doubt it.